NO EASY WAY OUT

‘Opioid Cure’ Kratom Ruins Lives, Too

A battle is brewing over the botanical substance known as kratom. Users say it’s safer than opiates, while critics call it just as dangerous.

09.29.16 1:00 AM ET

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One mother says that her son stole $7,000 in checks from his dad to fuel his drug addiction, went to rehab, relapsed, and then committed suicide by driving his car into an overpass. His last known words: “I can’t live like this anymore.”

A 33-year-old man took the same drug and had grand mal seizures so powerful he “broke the bed straps” in the emergency room. He had never had seizures before.

A 61-year-old woman “heard voices” while taking the drug and then “brought [her] 6 ft. ladder to [her] neighbors’ backyard” because she “imagined they needed help.” She fell in the middle of the psychotic episode and fractured her wrist.

The stories—all found in Food and Drug Administration (FDA) case reports obtained by The Daily Beast with personal identifying information redacted—aren’t about heroin. They’re about kratom, an obscure botanical substance derived from Southeast Asian trees and sold online as a dietary supplement in the United States.

Kratom has both stimulant and sedative effects depending on the dose, according to the DEA. Defenders say that it is a relatively harmless recreational drug as well as a safer alternative to opioid use for chronic pain sufferers and opioid addicts. It is the latter narrative that has most captured the imagination of the press this year.

In June, for example, Gizmodo staff writer Bryan Menegus romanticized kratom as “the herb of last resort for recovering addicts,” telling the story of an 18-year-old oxycodone addict who says he used kratom to shake off his painkiller habit and hold down a job. These sorts of anecdotes often appear in defenses of kratom, which have only been increasing in frequency as the DEA ban draws near.

Earlier this week, for example, a Vice columnist speculated that the DEA scheduling could “make life even more dangerous for U.S. heroin users,” based on the debatable notion that kratom helps opioid addicts treat withdrawal. The next day, Scientific American warned that the kratom ban could “cripple promising painkiller research,” citing a mouse study. And subscribers to the r/kratom subreddit have been petitioning and calling local DEA offices all week to try to stop the ban. Even 51 members of Congress asked Obama to intervene on Tuesday, arguing that researchers need more time to “investigate the use of kratom as a remedy for opioid withdrawal.”

But so far, federal agencies like the DEA, the FDA, and the Centers for Disease Control and Prevention (CDC) are standing by their stance: As beloved as kratom may be online, it just isn’t safe.

It’s easy enough to find anecdotes that run counter to the addiction recovery stories that are often found in defenses of kratom. Earlier this year, for example, The New York Times interviewed addicts in South Florida who tried to wean themselves off of other drugs with kratom but ultimately became hooked on the substitute, too. One woman, Dariya Pankova, went back to heroin after trying to use kratom to treat her withdrawal symptoms. Another addict, Robert Waina, said he had to go to rehab for kratom three times.

Scholarly research has also shown that kratom can be addictive. A 2014 study of 293 regular users in Malaysia published in Drug and Alcohol Dependence found that over half had “developed severe kratom dependence problems.” Withdrawal symptoms recorded in the study included “muscle spasms and pain, sleeping difficulty, watery eyes/nose, hot flashes, fever, decreased appetite and diarrhea” as well as “restlessness, tension, anger, sadness, and nervousness.”

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Meanwhile, adverse incidents involving kratom have kept the drug on the federal government’s radar for years. The FDA has had an “import alert” out on kratom since February 2014 and the DEA has listed it as a “drug of concern.” The reasons why: It can be addictive and potentially dangerous.

In its notice of intent to register kratom as a Schedule I drug—which means that it has “no currently accepted medical use and a high potential for abuse”—the DEA warned that the “consumption of kratom individually, or in conjunction with alcohol or other drugs, is of serious concern as it can lead to severe adverse effects and death.” The DEA also said that it was “especially concerning” that people have been trying to treat heroin withdrawal with kratom.

A DEA spokesperson told The Daily Beast that the congressional letter is being “taken under advisement” but reaffirmed the agency’s overall concerns.

According to a press release from the FDA, too, the plant by no means provides a guaranteed safe high. It “can lead to a number of health impacts including respiratory depression, vomiting, nervousness, weight loss and constipation.” Withdrawal symptoms, the FDA added, “may include hostility, aggression, excessive tearing, aching of muscles and bones and jerky limb movements.”

And the CDC has called the spread of kratom an “emerging public health threat” based on a tenfold increase in kratom-related calls to poison control centers over the last five years. Medical case reports, the CDC notes, have linked kratom exposure to “psychosis, seizures, and deaths.” Although severe outcomes in these calls were rare, they weren’t rare enough: Over 7 percent of recorded kratom-related calls involved “life-threatening” symptoms.

Part of the problem has been that kratom is distributed in dietary supplements, which are subject to different—and less stringent—FDA regulations.

In the FDA case reports obtained by The Daily Beast, several people who self-medicated with kratom appear to have had no awareness of the adverse effects that have since led to its DEA scheduling.

“I thought it was a dietary supplement which it says on the package,” one man wrote, saying he “though [sic] it was an energy pill.”

“I would not have been taking those pills had I known what they would do to me,” he added.

One woman who had to be hospitalized for a life-threatening liver problem was drinking “large volumes of kratom tea to control symptoms of anxiety and chronic pain.”

And the young man who tragically committed suicide was taking kratom “to calm his nerves and help with anxiety attacks.”

When police arrived at the scene of the fatal car crash, as his mother noted in the case report, they didn’t find a note. They found eight bags of kratom: six empty, two full.

Update 9/29/16 6:40 PM: This article was updated to reflect the fact that the rescheduling of kratom could take effect as soon as—rather than on—September 30th. The DEA has not yet specified a date for the rescheduling.